{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:15:49Z","timestamp":1788423349301,"version":"build-2803163510"},"reference-count":42,"publisher":"Yeungnam University College of Medicine","funder":[{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["HS22C0046"],"award-info":[{"award-number":["HS22C0046"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-jyms.org"],"crossmark-restriction":true},"short-container-title":["J Yeungnam Med Sci"],"abstract":"<jats:p>Background: Middle adulthood (45\u201364 years) is a critical window for the primary prevention of cognitive decline and chronic diseases, and physical activity can reduce later cognitive decline by 20% to 35%. However, most evidence on mobile health (mHealth) interventions for physical activity comes from Western populations, with few evaluations of culturally adapted approaches for Asian middle-aged adults, particularly in rapidly aging South Korea.Methods: This 12-week, single-arm, pre-post pilot feasibility study enrolled 304 community-dwelling adults aged 45\u201364 years from Dobong-gu, Seoul, South Korea. The intervention combined a Samsung Galaxy Watch 6 with a custom application incorporating culturally adapted features (mountain-climbing gamification based on famous Korean peaks, adaptive goal setting, and context-aware notifications) developed through systematic focus groups. The primary outcomes were weekly step count and moderate-to-vigorous physical activity (MVPA); secondary outcomes included subjective cognitive function (validated self-report scale), exercise behavior stages, depressive symptoms, and app usability.Results: Overall, 302 participants (99.3%) completed the intervention. Weekly step count increased by 16.9% (78,334 to 91,531; p&lt;0.001) and weekly MVPA by 83.3% (56.0 to 102.6 minutes; p&lt;0.001). The proportion meeting World Health Organization physical activity guidelines increased from 23.2% to 42.1% (p&lt;0.001). Selective improvements occurred in executive function-related cognitive domains and depressive symptoms, and a dose-response relationship emerged between app engagement and step count gains.Conclusion: This culturally adapted wearable mHealth intervention showed high feasibility and acceptability for promoting physical activity in Korean middle-aged adults, supporting further evaluation as a scalable strategy for the primary prevention of cognitive decline and chronic diseases.<\/jats:p>","DOI":"10.12701\/jyms.2026.43.53","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:35:16Z","timestamp":1786325716000},"page":"53","update-policy":"https:\/\/doi.org\/10.12701\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Culturally adapted wearable mobile health intervention for physical activity and cognitive function in middle-aged Koreans: a pilot feasibility 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